Healthcare Provider Details

I. General information

NPI: 1982139531
Provider Name (Legal Business Name): ALEXANDRA MICHELE TUREK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALEXANDRA MICHELE PAYTON MD

II. Dates (important events)

Enumeration Date: 04/20/2017
Last Update Date: 06/24/2020
Certification Date: 06/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 FORBES ST STE 200
ANNAPOLIS MD
21401-1527
US

IV. Provider business mailing address

1707 VESTMENT CT
SEVERN MD
21144-1629
US

V. Phone/Fax

Practice location:
  • Phone: 410-263-6363
  • Fax:
Mailing address:
  • Phone: 410-935-1386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number227321
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0089224
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: